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Respiratory care

25,000 people a year die of Chronic Obstructive Pulmonary Disease (COPD) in the UK alone and the NHS spends £420 million a year directly on treating COPD with an estimated 1 tonne of CO2e per episode. In 2012, CSH was funded for a year by GSK, to run a project to improve the environmental sustainability of respiratory medicine, focusing in particular on COPD.

The project began by bringing together respiratory professionals, representatives from primary care, nursing, academic and the pharmaceutical industry at a Sustainable Respiratory Care summit, chaired by respiratory consultant, Dr Rob Winter. We focused on the environmental impact of COPD services, showing how the inclusion of environmental protection as a key driver alongside cost and quality of care can encourage innovation and ultimately produce a service which is preventative, personalised and efficient and makes best use of low carbon technologies. Opportunities explored ranged from lower carbon inhalers to better integration of primary, secondary and emergency care (see the summary statement).

“We have an opportunity to develop a paradigm of care for the 21st century, one which is better for patients and better for the environment. Healthcare has a responsibility not to follow but to lead on carbon reduction; respiratory medicine should be at the forefront." Dr. Robert Winter OBE, National Clinical Director for Respiratory Disease, 23 March 2012

Following on from the Summit, a Sustainable Respiratory Care advisory group was established, which identified three priority areas for research:

Inhalers

Early detection/prevention (by smoking cessation and physical activity) and

Home oxygen therapy.

The Centre's Sustainable Respiratory Care group has led research on why the UK continues to use inhalers with a much higher carbon footprint than other European countries. Following the Montreal protocol banning the use of CFC gases in 1987, many countries moved directly to a new technology for inhalers based on Dried Powder (DPIs) while the UK still prescribes a majority of metered dose inhalers (MDIs) which use powerful greenhouse gases and contribute as much as 5% of the total NHS carbon emissions.